Dekkers R J, FitzGerald D J, Couper G S
Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
Perfusion. 2001 Jan;16(1):13-8. doi: 10.1177/026765910101600103.
Mechanical support for the failing heart has interested and challenged cardiac specialists for decades. In the United States alone, there are close to 375,000 cardiac surgical procedures performed each year, and, despite the recent advances in myocardial protection, surgical techniques, intra-aortic balloon therapy and maximal pharmacological support, postoperative ventricular dysfunction continues to occur in 0.5-1.0% of all patients undergoing cardiac surgery. This retrospective review describes our 5-year clinical experience at the Brigham and Women's Hospital with the Abiomed BVS 5000 as a means of ventricular support. During the period of 1994 to present, 7,428 cardiac surgical operations were performed at our institution. The Abiomed BVS 5000 has been implanted in 47 patients exhibiting ventricular failure. There were 38 patients in the bridge-to-recovery group and nine patients in the bridge-to-transplantation group. Twenty-five patients (66%) in the bridge-to-recovery group were weaned and 16 patients (42%) went on to discharge. In the bridge-to-transplantation group, one patient actually recovered myocardial function and one expired on the device. The remaining seven patients (77%) underwent cardiac transplantation with post-transplant survival at 66%. Overall, patients were supported in the isolated left ventricular mode (28%), in the biventricular mode (45%) and in the isolated right ventricular mode (28%). The Abiomed BVS 5000 has been shown to be a safe and simple cardiac support system with no mechanical failure. Our experience shows that a substantial number of patients suffering from ventricular failure will benefit from the use of this device. The results also justify the use of this device in groups of patients other that of postcardiotomy ventricular failure.
数十年来，心脏功能衰竭的机械支持一直吸引着心脏专科医生并对他们构成挑战。仅在美国，每年就有近37.5万例心脏外科手术，尽管在心肌保护、手术技术、主动脉内球囊治疗和最大程度的药物支持方面取得了最新进展，但在所有接受心脏手术的患者中，仍有0.5%-1.0%会出现术后心室功能障碍。这项回顾性研究描述了我们在布莱根妇女医院使用Abiomed BVS 5000作为心室支持手段的5年临床经验。在1994年至今的这段时间里，我们机构共进行了7428例心脏外科手术。Abiomed BVS 5000已植入47例出现心室衰竭的患者体内。其中有38例患者属于恢复前过渡组，9例患者属于移植前过渡组。恢复前过渡组中有25例患者（66%）成功撤机，16例患者（42%）出院。在移植前过渡组中，有1例患者心肌功能实际恢复，1例患者在设备上死亡。其余7例患者（77%）接受了心脏移植，移植后生存率为66%。总体而言，患者接受的支持模式为单纯左心室模式（28%）、双心室模式（45%）和单纯右心室模式（28%）。Abiomed BVS 5000已被证明是一种安全、简单且无机械故障的心脏支持系统。我们的经验表明，大量患有心室衰竭的患者将从使用该设备中受益。这些结果也证明了在除心脏术后心室衰竭患者之外的其他患者群体中使用该设备的合理性。
